Incidence and severity of phlebitis in patients receiving peripherally infused amiodarone

Background Nurses noted that the rate of phlebitis was high when intravenous amiodarone was infused via a peripheral site. Hospital policy recommends a central vascular catheter, but this method is often not feasible because the drug is administered in emergent situations for short periods. Objective To determine the rate and severity of phlebitis in patients given peripherally infused amiodarone. Methods The literature, policy, and procedures for administration of amiodarone were reviewed; the pharmacy was consulted; and a data collection tool was developed. The tool was pilot tested and revised, and face validation was established. Data were collected during a 6-month period. A convenience sample was used. Results The study included a total of 12 patients. Each new infusion of intravenous amiodarone was considered a separate occurrence, for a total of 24 infusions. Various grades of phlebitis developed in 8 patients (67%). Phlebitis developed at 12 of the 24 infusion sites (50%). Conclusions Patients receiving peripherally infused amiodarone are at high risk for phlebitis. This complication may lead to infection, additional medical intervention, delay in treatment, and prolonged hospitalization.     

五马膏局部热敷预防甘露醇静脉点滴致静脉炎的研究

目的探讨局部五马膏热敷对局部组织血管的影响。方法90例确诊为腰椎间盘突出症患者静脉点滴20％甘露醇540例次,随机分实验组和对照组。实验组静滴后沿静脉走向距针眼2cm处热敷五马膏30min,对照组不作处理,观察两组静脉炎发生率。结果实验组静脉炎发生率8．87％,对照组静脉炎发生率33．33％,两组比较差异有统计学意义（χ2=6．67,P〈0．01）。结论局部五马膏热敷的护理,可减少静脉炎发生率,减轻患者痛苦。     

5％葡萄糖注射液对盐酸胺碘酮注射液所致静脉炎的效果评价

目的探讨5％葡萄糖注射液对胺碘酮所致静脉炎的效果。方法将2011年6月一2012年3月收治的136例患者随机分为对照组63例和干预组73例。对照组遵医嘱以5％葡萄糖注射液500mL加胺碘酮注射液600mg以15滴／min静脉输注,1次／d,连续使用3d;干预组在对照组输液治疗的基础上同时以5％葡萄糖注射液冲管,比较两组患者静脉炎并发症的发生率。结果对照组发生静脉炎22例（34．9％）,干预组发生静脉炎11例（15．0％）,两组比较差异有统计学意义（χ2=7．252,P=0．007）。结论输液治疗同时以5％葡萄糖注射液冲管可明显降低胺碘酮所致静脉炎的发生。     

医用水凝胶对白血病PICC置管患者静脉炎及满意度的影响

目的 探讨医用水凝胶对白血病PICC置管患者静脉炎及满意度的影响。方法 将我院2016年1月至12月期间收治的采用PICC置管的160例患者按照随机抽样分组,对照组80例给予常规护理和湿敷,观察组80例给予常规护理和湿敷的基础上加用医用水凝胶,比较两组患者静脉炎的情况发生率、干预时间(静脉炎的发生时间)、舒适度及护理满意度。结果 观察组的静脉炎发生率低于对照组,严重程度轻于对照组,发生时间晚于对照组,差异有统计学意义(P<0.05)。观察组执行干预所需时间短于对照组,PICC舒适度高于对照组,护理满意度高于对照组,差异有统计学意义(P<0.05)。结论 医用水凝胶能够预防白血病PICC置管患者静脉炎的发生,提高患者期间的舒适度和护理满意度,减少护理人员工作量,值得推广。     

六神丸与利多卡因联合高氧液热敷治疗机械性静脉炎的效果

目的探讨六神丸、利多卡因联合高氧液温热敷治疗PICC所致机械性静脉炎的效果。方法将因PICC所致机械性静脉炎的患者84例随机分为观察组和对照组,各42例。观察组用六神丸30—60粒研成粉末,2％利多卡因3～5ml调和至完全溶解后均匀涂抹于患处,用浸有高氧液的无菌纱布外敷,保鲜膜固定,外用内装40～42℃水的热水袋温热敷;对照组用50％硫酸镁湿敷,外用保鲜膜固定。均定时更换。于治疗后的第3天和第5天观察效果。结果第3天观察组有效率为92．85％;对照组有效率为50．00％,两组比较差异有统计学意义（H=15．8472,P〈0．01）;第5天观察组有效率为97．62％;对照组有效率为61．90％,两组比较差异有统计学意义（H=26．7660,P〈0．01）。在I级和Ⅱ级静脉炎的治疗上,观察组疗效更为显著（H分别为10．0744,23．0210;P〈0．01）。结论六神丸、利多卡因联合高氧液温热敷治疗PICC所致机械性静脉炎疗效显著,值得临床推广使用。     

静脉留置针患者发生静脉炎的影响因素分析

目的分析静脉留置针患者发生静脉炎的相关因素,为制定相应的预防护理措施提供依据,以提高输液护理质量。方法选择静脉留置针患者142例,分析患者性别、年龄、相关血液学指标、留置时间及封管方法对其静脉炎发生情况的影响。先进行单因素分析,再采用强迫法建立模型,用Logistic多元回归分析影响静脉炎发生的因素。结果本组发生静脉炎51例,发生率为35.9%。静脉炎发生与患者性别、留置静脉套管针的时间有关;与年龄、相关血液学指标及封管方法均无关。结论留置时间越长,发生静脉炎的可能性越大,女性较男性静脉炎发生率高,应尽可能缩短静脉留置套管针的时间,并加强对留置静脉留置针的女性患者的观察。     

新生儿静脉留置针发生静脉炎的危险因素及防范对策分析

目的分析静脉留置针发生静脉炎的危险因素及防范对策。方法选取2016年2月至2018年12月于我院新生儿病区住院的患儿1283例,分析影响患儿静脉留置针发生静脉炎的影响因素。结果本研究1283例新生儿静脉留置针共发生静脉炎78例(6.08%)。发生组出生时体重<3000 g、出生前孕周<37周、下肢留置、药液pH<5或>9、留置针时间>5 d、抢救时留置针及未一次性穿刺成功的患儿占比高于未发生组(P<0.05)。多因素Logistic回归分析显示,下肢是否留置、药液pH值、留置针时间、留置时机为患儿静脉炎发生的独立危险因素(P<0.05)。结论静脉炎与患儿出生时体重低、出生前孕周短、下肢静脉留置、药液pH<5或>9、留置针时间长、抢救时置针、未一次性穿刺成功等因素相关,综合防范可降低新生儿留置针静脉炎的发生率。     

Phlebitis in peripheral catheters (I). Incidence and risk factors

The type of pathology and the current therapeutic tendencies justify that endovenous therapy is the most frequently selected one. Although it has multiple advantages, it bears with it a series of infectious type complications (bacterial infections, phlebitis and thrombophlebitis). Even though bacterial infections in peripheral intravascular vessels have a low occurrence rate, which some authors list as between 1 and 2%, in central intravascular vessels, their occurrence is usually higher. Phlebitis is one of the complications most frequently associated with the use of peripheral intravascular catheters.     

Effectiveness of an Intravenous Protection Device in Pediatric Patients on Catheter Dwell Time and Phlebitis Score

PurposeThe study aimed to examine the efficacy of the I.V. House UltraDressing for protecting peripheral intravenous catheters (PIVCs) in pediatric patients.MethodsThis randomized controlled trial comprised 60 pediatric patients (aged 2–24 months): 30 in the experimental group and 30 in the control group. The PIVC dwell time and phlebitis scores were also reported for both groups. The degree of phlebitis was determined using the Visual Infusion Phlebitis Scale (VIPS) and was recorded every 8 hours from the start of antibiotic therapy until catheter removal.ResultsThe mean catheter dwell time in the experimental group (2.10 ± 1.55 days) was significantly longer than that in the control group (1.27 ± 0.45 days) (p < .01). However, there were no significant differences between the scores and signs of phlebitis in both groups (p > .05).ConclusionThe I.V. House UltraDressing is a useful device that can be used to increase catheter dwell time and protect and stabilize PIVCs in pediatric patients.     

Predisposing factors to phlebitis in patients with peripheral intravenous catheters: a descriptive study

PURPOSE: The purpose of this study was to investigate the predisposing factors in the development of phlebitis in peripheral intravenous (IV) catheterization sites in patients treated with a variety of IV infusion solutions and drugs. DATA SOURCES: Systematic observation of 568 IV sites inserted for fluid infusion and drug administration in 355 patients in the Department of General Surgery of a University Hospital in Turkey. A data collection tool was based on standards established by the Infusion Nurses Society. Patients' infusion sites were monitored every 24 h during treatment and for 48 h after discontinuation of the IV. CONCLUSIONS: In contrast to the usual findings in the literature, the authors found that infusion through an infusion pump and insertion of catheters in the veins around the elbow increased the risk of phlebitis. Also, the number of times infusions were started led to an increased rate of phlebitis. However, conflicting results were obtained about the relation between phlebitis, gender, and catheter size. IMPLICATIONS FOR PRACTICE: Phlebitis causes sepsis, pain, additional diagnostic investigations, and treatments, and may lead to increased duration of hospitalization, patient's stress level, and financial burden, as well as increasing staff workload. Advanced practice nurses need to be aware of the factors that increase the likelihood of phlebitis and take appropriate measures to prevent it.     

年龄、血管条件与骨科患者静脉留置针所致静脉炎的相关性研究

目的 探讨年龄、血管条件与静脉留置针所致静脉炎的相关性,寻求安全的使用方法.方法 采用静脉炎调查分析量表,对608例骨科患者使用静脉留置针的情况进行调查分析.结果 有43例患者发生静脉炎,男女之间静脉留置针所致静脉炎发病率差异无统计学意义(P＞0.05);各年龄组间发病率整体比较差异无统计学意义(P＞0.05);随着患者年龄增加,留置针所致静脉炎发病率逐渐上升;不同血管评分分组之间发病率整体比较差异有统计学意义(P＜0.05),血管条件越差,留置针所致静脉炎发生率越高.创伤、关节、脊柱及骨肿瘤等亚专业组间发病率整体比较差异无统计学意义(P＞0.05).结论 留置针所致静脉炎与患者年龄、血管评估条件相关,而与性别和疾病种类无关.     

Phlebitogenicity of venous catheters of Vialon

During three days 132 surgical patients with postoperative infusion treatment were checked on the frequency of venous reactions in the arms when catheters/cannulas of 4 different materials were used and the outcome compared. A significant result was obtained in connection with the I-cath catheter made of vialon (a polyurethanelike resin polymer) and the L-cath of polyurethane. Phlebitis was decreased to 27.3% resp. 24.2% - approximately half of its usual frequency - when I-cath of polyvinyl-chloride and FEP-teflon vasofix cannulas were applied (both 51.5%). The different predisposing factors of infusion phlebitis are under discussion.     

静脉留置针留置期间碘伏消毒的效果观察

目的探讨静脉留置针留置期间消毒方法,及其与静脉炎发生的关系。方法采用自身对照法,分别在同一病人的左右前臂头静脉用留置针进行输液,隔日更换敷帖,常规组使用2%碘酊、75%酒精消毒皮肤,碘伏组使用5%碘伏消毒皮肤,观察两组静脉炎的发生率。结果常规组静脉炎发生率明显高于碘伏组(字2=5.37,P<0.05)。结论静脉留置针留置期间局部皮肤消毒剂的种类与静脉炎发生率有关。临床护士使用静脉留置针留置期间更换敷帖消毒时,以5%碘伏消毒皮肤,可降低静脉炎的发生率,延长置管时间。     

Chlorhexidine or povidone-iodine and alcohol: A pilot study for evaluating the incidence of phlebitis in neonates

BackgroundPhlebitis is a complication of peripheral venous catheter placement in neonates, and is a criterion for the quality of nursing care. It seems that choosing the right solution for disinfecting the catheter site can help reduce these complications. The present study aimed to compare chlorhexidine with Povidone-iodine alcohol on the incidence of phlebitis in preterm neonates.MethodsThis quasi-experimental study was conducted in the Neonatal Intensive Care Unit (NICU) in Alborz province- Iran in 2020. A total of 106 neonates, who met the inclusion criteria, were randomly assigned to group A (n = 53) and group B (n = 53). The Povidone-iodine-alcohol solution in group A and chlorhexidine gluconate solution in group B were used to disinfect the peripheral venous catheter site. The catheter placement site was monitored every 8 h and before each injection using the Visual Infusion Phlebitis Scale.ResultThe research results indicated that in participants, who used chlorhexidine after 48 h, the mean score of phlebitis was 0.14 ± 0.07, and in the group who used Alcohol-Povidone-iodine it was 0.68 ± 0.190. Also, there was a statistically significant difference between the two groups (p-value = 0.003).ConclusionChlorhexidine was more effective in reducing the incidence of phlebitis than Povidone-iodine and alcohol in neonates.     

Complicaciones relacionadas con la inserción y el mantenimiento del catéter venoso central de acceso periférico

ObjectiveTo evaluate the rates and nature of the complications related to the Central Peripheral Access Catheter (CVCAP or PICC) from its insertion to its withdrawal.MethodsProspective observational study. All patients older than 14 years of age with a PICC inserted in the polyvalent intensive care unit (ICU) during the period between May 1, 2015 and April 30, 2016 were included. Data collected included: demographic data, insertion details, reason for insertion and removal, maintenance unit, total dwell time, incidence of complications and related factors and infection rate.Results144 PICCs were inserted, of which 94 corresponded to the ICU group (65.28%) and 50 (34.72%) to the non-ICU group. The most important complication was the suspicion of infection: 17.36% (rate of 15.2 per 1000 days of PICC). The total number of confirmed infections was 6.25% (5.5 per 1000 days of PICC), 1.39% (1.2 per 1000 days) being in the ICU group and 4.86% (4.2 per 1000 days) in the non-ICU group. There were 5 bacteraemias, all in the non-ICU group (3 per 1000 days). The most frequent germ was Staphylococcus epidermidis (6 cases). Phlebitis had an incidence of 9.03% (7.9 per 1000 days of PICC).ConclusionsPICC, effective device for central venous access due to the minimal incidence of risks in implantation and to its advantages with regard to the classic central venous catheters, is a further nursing technique.     

七叶皂甙钠不同滴速与静脉炎关系的临床研究

目的：观察七叶皂甙钠不同输液速度对静脉炎的影响。方法将静脉输注七叶皂甙钠的84例患者随机分为观察组48例和对照组36例,观察组输液速度为60～70滴/min ,对照组滴速为30～40滴/min。观察两种输液速度对静脉炎的影响。结果观察组静脉炎发生率41．6％（20/48）,其中Ⅰ级18例,Ⅱ级2例;Ⅲ级0例;对照组静脉炎发生率77．7％（28/36）,其中Ⅰ级16例,Ⅱ级11例,Ⅲ级1例。观察组的静脉炎发生率小于对照组,差异有显著意义（P＜0．05）。结论加快七叶皂甙钠的输液速度可以显著减少静脉炎的发生率。     

Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters.

Approximately 150 million peripheral intravenous (PIV) catheters are inserted annually in the United States, with a 5% incidence rate of phlebitis as an acceptable benchmark. In 2002, the Centers for Disease Control and Prevention recommended that PIV sites and administration sets be changed at least every 96 hours, yet clinical practice supported that at least 25% of PIV catheters showed no signs of phlebitis at 96 hours' dwell time. This study reports the assessment results of 850 PIV catheters over the indwelling life of the catheter, using the Visual Infusion Phlebitis scale as the measure determining when a PIV should be removed.     

康惠尔透明贴防治乳腺癌术后首次化疗致静脉炎的疗效观察

目的：观察康惠尔透明贴防治表阿霉素（E-ADM）联合用药致静脉炎的临床效果。方法：将160名第1次大剂量（100mg/m^2）静脉滴注表阿霉素的乳腺癌术后患者按床号的单双数随机分为对照组和实验组各80例,静脉穿刺处对照组使用3M透明贴,实验组使用康惠尔透明贴,观察两组患者静脉炎发生率及严重程度。结果：对照组发生静脉炎31例,实验组发生静脉炎9例。两组经秩和检验,W=6.638,P=0.0353。结论：使用康惠尔透明贴能有效预防表阿霉素联合用药所致的静脉炎,值得临床推广应用。     

Nurses' knowledge regarding patients with intravenous catheters and phlebitis interventions.

This study was planned and applied in 2 stages. Stage I was applied to determine the knowledge of nurses working in the internal medicine, surgery, obstetrics and gynecology, pediatrics, and other services in Celal Bayar University Hospital about using intravenous catheter and intravenous fluid treatment, and the symptoms and treatment procedure for phlebitis. Stage II consisted of observation of all patients who had intravenous catheters for symptoms of phlebitis for 5 days and the interventions the nurses used for the patients who had phlebitis. In stage I, questionnaires were used to determine the knowledge of the nurses; in stage II, 2 investigators observed the patients. Results were evaluated using SPSS software with chi(2) statistical analysis. Nurses were found to have high knowledge levels, but their practices were not suitable to their knowledge levels. Of the patients who participated in the study, 67.24% showed symptoms of phlebitis. We found that there was a significant relationship (P <.05) between the selection of the vein and the occurrence of phlebitis in patients who had an intravenous catheter. We also found that the relationships between the age groups of the patients and phlebitis and the relationships between the diagnosis and phlebitis were statistically significant (P <.05).